This invention relates to a new and improved surgical endoclip adapted to be used with either the well known U.S. Surgical Corporation type applier which has achieved widespread use and sometimes is known by the trademark Auto Suture or a modification thereof.
Surgical endoclips are metal devices used to occlude ducts or vessels during surgical procedures. When two clips are applied to a duct or vessel the duct can be severed between them, and if the clips are properly applied and secured, leakage of fluid, such as blood or bile is prevented. Ultimately, the structure occluded by the clip is permanently stenosed and sealed by normal healing processes. The device used to apply an endoclip can be used for both open and closed, laparoscopic, surgical procedures.
Prior endoclips, made of titanium, are generally U-shaped with the legs squeezed together to seal a vessel. Such clips have a tendency to come off the ducts or vessels to which they have been applied, in part, because the legs may tend to spread apart. Clips have been observed coming off along the transverse axis along which they had been applied as they were being placed and immediately after they had been placed. Such clips also can work themselves off in the severed end of the duct or vessel along the long axis. In either case, the vessel lumen would cease to be effectively occluded, and bile or blood would be free to leak into in postoperative patients which has sometimes led to surgical reexploration, transfusion therapy and other untoward complications. Since these problems are not uncommon, the inventors have provided a new endoclip to reduce the risk of slippage after application.
One of the approved current clips is designed so that the inner surfaces of the U-shaped arms are smooth. Another current clip is designed so that the inner surfaces of its U-shaped arms are corrugated. However, after application, both clips are open and free at one end, even though they are squeezed down across the duct and thus, may slip off the duct along its transverse axis. The occlusions created by and the positions of these clips across the duct are maintained solely by virtue of titanium's lack of "memory"--i.e., once crimped, the clips tend to remain crimped. These clips are not secured in any way other than by squeezing or crimping them across the duct after the clip has been properly placed.
U.S. Surgical Corporation has been very successful in promoting its Auto Suture Disposable Clip Applier. This applier is the subject of several U.S. patents, for instance, U.S. Pat. Nos. 4,242,902 and 4,616,650. These patents illustrate that the surgical clips are fed in a cartridge-like fashion between two jaws 103 (FIGS. 14-19 of U.S. Pat. No. 4,616,650), and the patents illustrate the operation of the U.S. Surgical Clip applier and the cartridge fashion in which such clips are supplied.
U.S. Pat. No. 4,834,096 disclosed a plastic ligating clip which uses a special manual instrument to close the plastic clip and stop the flow of fluid. The subject of the '096 patent is directed to a plastic clip which, in part, is to eliminate metal clips which are objectionable for the reasons set forth in the '096 patent. The '096 clip closes completely around the vessel to which it is secured. The '096 patent presents a special instrument to apply the plastic clip, and the plastic clip is unable to be used with the U.S. Surgical Auto Suture.
There are several other clip tool manufacturers that supply tools that apply clips "manually" i.e., one at a time, "muzzle loaded". This invention is adapted to be used with such surgical clip appliers.
An object of this invention is to provide a surgical clip which may be used with widely accepted types of surgical clip appliers, such that the clips are supplied in a cartridge form to be applied one after another by the surgical clip applier.
Another object of this invention is to provide such a surgical clip which circumferentially surrounds the duct to be closed in a more effective and efficient fashion than prior clips so as to prevent the slippage of such improved endoclips from the duct.
Still another object of this invention is to provide such an improved surgical clip which will find ready acceptance in the medical field, may be easily utilized with existing technology and provide enhanced benefits.
Another object of this invention is to provide such a surgical endoclip with nubbins formed on a holding surface thereof to further hold the clip on the duct being occluded when the clip is closed.
Yet another object of the present invention is to positively secure the ends of titanium surgical clips together to ensure the clip's attachment to a vessel.
Other objects, advantages and features of this invention become more apparent from the following description.